Hypothermia patient survives after nearly 9 hours of CPR

After nearly 9 hours of continuous CPR, a young British man’s heart began beating. The patient, a severely hypothermic hiker, was found in a remote mountainous area of Norway by other hikers and received several hours of manual CPR before rescuers were able to fly him to definitive care and continue CPR with a LUCAS device. According to NRK.no, the Norwegian Broadcasting Corporation, after 8 days, the patient was taken off the ventilator, “awake and speaking clearly.”

The story of the patient’s rescue, hours of manual CPR from a group of strangers in a backcountry cabin, and a record-setting 8 hours, 48 minutes of CPR is a compelling read. It’s also a reminder that hypothermia isn’t just a dead of winter, bitter cold emergency. The patient was discovered on August 5, on a day that was windy, rainy and temperatures just above freezing. Hypothermia can happen when heat loss exceeds heat production and heat retention. The article doesn’t have information about the patient’s activities on the day of the incident or his health history.

Watch a summary of the news report

Here’s how the chain of survival saved the hiker’s life.

1. Lifesaving starts with bystanders

The two hikers who discovered the patient acted quickly to move the patient to a temporary shelter from the elements and placed him on a sleeping pad to reduce conductive heat loss. One of the hikers went to a cabin several kilometers aweay to get help.

2. Have a plan for when help arrives

The top treatment priority for the patient is to end a cold challenge, which meant evacuation to the cabin for protection from the cold, wind and heavy rain. When other hikers arrived, they began the difficult task of carrying the patient almost 3 kilometers. Their urgency and difficulty increased when the patient became unresponsive.

3. End the cold challenge

At the cabin, they removed the patient’s wet clothes and placed him on an insulating pad. Any patient that’s unresponsive needs regular, near constant ABC reassessment. Next, treat what you find with the tools and training you have.

4. Lifesaving continues with basic life support

At about 10 p.m., the eight hikers in the cabin began CPR, chest compressions and rescue breaths. Chest compressions keep blood circulating to the patient’s brain and heart, while mouth-to-mouth rescue breaths deliver warm, humidified, oxygenated air to the patient.

Calling for ALS help and evacuation is an important part of the BLS treatment plan. A helicopter arrived, but was unable to land. A second helicopter landed after midnight and 2 hours of manual CPR came to an end when the patient was transferred to a mechanical CPR device.

5. ALS continues to support ABCs

The patient’s core temperature was 20.4 C (68.7 F). Field rewarming with warm IV fluids, warm air ventilation, heat packs in the packaging, and high ambient temperature isn’t enough to successfully rewarm the patient. Chest compressions and other interventions, though not stated in the news article, like IV fluids, intubation, and mechanical ventilation, were likely administered by the ALS crew during urgent transport.

6. Definitive hospital care

According to the article, the patient received heart lung bypass (ECMO) at the hospital and was slowly rewarmed. After 8 hours, 48 minutes of CPR, the patient ’s heart began to beat on his own, ROSC.

Senior Consultant André Roslin, a member of the helicopter rescue team, said, “We believe this is the longest successful resuscitation of a hypothermic person ever documented.”

Read Roslin’s clinical abstract, page 12, in the Journal of the Norwegian Society of Anesthesiology.